Evaluation of glomerular filtration function in critically ill children by means of fibroblast growth factor 23

Objective To analyze the relationship between serum fibroblast growth factor 23 (sFGF23) and glomerular filtration function in critically ill children, and to investigate the predictive value of sFGF23 in glomerular filtration rate in critically ill children. Methods This prospective study included the children from the Pediatric Intensive Care Unit (PICU) of Children′s Hospital of Soochow University from May to August in 2012.A total of 143 critically ill children aged 1 to 156 months and weighing 2.5 to 46.0 kg were included.The levels of sFGF23 were measured on the first day of admission.The pediatric risk of mortality Ⅲ score (PRISM Ⅲ) was calculated based on 16 items which were collected during the first 24 hours of admission.Multivariable linear regression analysis was used to assess the relationship between sFGF23 and estimated glomerular filtration rate (eGFR). A receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were calculated to assess the predictive strength. Results Of the total 143 children, 8 cases (5.4%) died during the first week of admission to PICU.Regression analysis showed that sFGF23 levels were significantly associated with eGFR, even after adjusted for age and body weight, and sFGF23 achieved AUC of 0.741 for predicting eGFR, which was statistically significant(95%CI: 0.624-0.858, P=0.002). Conclusions sFGF23 has a good correlation with glomerular filtration function in critically ill children.The sFGF23 has certain clinical application value in evaluating glomerular filtration function in the critically ill children. Key words: Critically ill; Child; Fibroblast growth factor 23; Glomerular filtration function